Breathlessness from the Perspective of the Persian Medicine.

Dyspnea is one of the most complaints in the pulmonary diseases. Shortness of breath as a subjective symptom can decrease the quality of life of patients. Although symptomatic treatment of the patients with chemical drugs is efficient in sign reduction, drugs side effect and allowing the disease to become chronic are risky for patients. Nowadays, traditional medicine is considered as an effective strategy in patients' treatment by World Health Organization. This study discusses the causes of shortness of breath from the view of Iranian traditional medicine and describes some suggestion for treatment of causes of this problem. Persian medicine prioritizes prevention of diseases by offering some strategies. In case of disease occurrence, life style modifications and herbal pharmaceutical therapy are recommended.


INTRODUCTION
Difficulty in breathing described as feeling of "shortness of breath", "cannot get enough air", and "tightness in the chest" is referred to as breathlessness and the medical term for it is dyspnea (1).
Many pulmonary conditions such as pulmonary  It has been commonly prescribed for chronic cough, shortness of breath and rhinitis in the past 1000 years.

Maidenhair fern (Adiantum capillus-veneris)
Aerial parts and leaves of this plant are used for treatment of respiratory diseases (7). At present, this drug is used in cough medicines manually prepared by pharmacists (8). Razi in his famous book "Al Havi" states that "Maidenhair fern is a thin plant, which grows by the raceways and quickly loses its effect. It cleans the lungs from thick sputum" (9). Avicenna also believed that this medicinal plant is very effective for cleaning of the lungs and treatment of cough (3).

Liquorice (Glycyrrhiza glabra)
Although Liquorice is known as a gastrointestinal medication among people, animal studies have confirmed its efficacy for decreasing the degree of inflammation of lung parenchyma and pulmonary fibrosis (10). Also, Liquorice root is used for treatment of severe coughs.
Avicenna recommended it for cleaning of respiratory tract and treatment of hoarseness.

Fennel (Foeniculum vulgare)
Romans believed that snakes use fennel to strengthen their vision. Antibacterial effects of fennel oil have been confirmed in pulmonary patients (11). Also, antiinflammatory, antimicrobial and bronchodilator effects of fennel have been previously reported (12). Avicenna recommended addition of green fennel to breast milk to treat shortness of breath in infants (13).

Fenugreek (Trigonella foenum-graecum)
Recent studies have confirmed the efficacy of fenugreek for decreasing the symptoms of nasal congestion, sinusitis, cough and sputum production due to its mucolytic properties (14). Seeds of this plant are rich in proteins, lysine, tryptophan, saponin and diosgenin, and contain large amounts of soluble fibers such as hemicellulose, saponin, mucilage, tannin and pectin, which are used for treatment of diabetes mellitus and hypercholesterolemia (15).Razi recommended its cooked form for chronic chest pain without fever and its electuary for shortness of breath (9).Avicenna recommended it for hoarseness and stated that its dressing is suitable for pleurisy when applied on chest (3).

Quince (Cydonia oblonga Miller)
Its seed glaze is used as a remedy for cough in many parts of the world. Anti-allergic effects of its boiled extract have been previously confirmed as well and its leaves and seeds are used for treatment of bronchitis and chronic cough (16). Evidence supports the anti-oxidant and antimicrobial properties of some parts of this plant as well.
However, toxic effects of chewing the seed must also be taken into account (17,18).
Avicenna recommended its lozenge with honey or boiled barley for shortness of breath and also prescribed it for treatment of diaphragm wounds (19). Razi also used this plant in his remedies for shortness of breath and cleaning of the lungs from thick sputum. However, new evidence regarding pulmonary effects of this plant is scarce.

Althea (Althea officinalis)
All parts of this plant produce a lot of glaze. Its boiled flower is effective for treatment of common cold and fever and is very beneficial for dry coughs (20).

Saffron (Crocus sativus)
Avicenna discussed the effects of saffron on shortness of breath and stated that "saffron is highly beneficial for treatment of breathlessness due to its effect on respiratory tract" (3).

Sweet violet (Viola odorata)
Evidence shows that sweet violet can treat children's cough (21). Jorjani prescribed it along with marshmallow plant for treatment of patients with pleurisy (22).